| Understanding risk evaluation and mitigation strategies in organ transplantation. | |
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MedLine Citation:
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PMID: 21923459 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Abstract The United States Food and Drug Administration (FDA) Amendments Act of 2007 mandated that Risk Evaluation and Mitigation Strategies (REMS) be required of manufacturers. These REMS are strategies implemented to manage known or potential risks associated with drugs and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product, including once the product becomes available as generic. The elements of an individual REMS program consist of three levels: medication guide or patient package insert, communication plan, and elements to assure safe use (ETASU). A medication guide or patient package insert is used to help prevent serious adverse events, aid in patient decision making, and enhance drug adherence. Communication plans are used to educate health care providers and to encourage their compliance with REMS. The ETASU is a restrictive process that is implemented when it is deemed necessary to ensure that patients have safe access to products with known serious risks that would otherwise be unavailable. To review the components of REMS and specifically assess their impact on health care providers practicing within the organ transplantation arena, a literature search of the MEDLINE database (January 2007-December 2010) was performed, and published materials from the FDA and its Web site were also reviewed. In transplantation, REMS programs exist for both everolimus (medication guide and communication plan) and sirolimus (medication guide). The FDA has stated that all mycophenolic acid derivatives will be subject to a proposed REMS that has not yet been approved; however, both branded mycophenolic acid agents already have approved medication guides. The REMS are a permanent fixture in the development and marketing of pharmaceutical agents, and their further implementation in solid organ transplantation is inevitable. Transplantation providers should take a proactive role in patient education and implementation of REMS within the therapeutic area. It is imperative for health care providers to realize that the ultimate goals of REMS are to reduce the potential for serious risks and to make outcomes from the treatment of disease more predictable. |
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Authors:
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Steven Gabardi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pharmacotherapy Volume: 31 ISSN: 1875-9114 ISO Abbreviation: Pharmacotherapy Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-09-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8111305 Medline TA: Pharmacotherapy Country: United States |
Other Details:
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Languages: eng Pagination: 714-22 Citation Subset: IM |
Affiliation:
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1 Departments of Pharmacy Service and Transplant Surgery, and the Renal Division, Brigham and Women's Hospital, and the Department of Medicine, Harvard Medical School, Boston, Massachusetts. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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